Dr. Usman's Cardiology Notes

Tc-99m PYP Imaging for Cardiac Amyloidosis -- Introduction Cardiac amyloidosis is an under-recognized cause of heart failure with preserved ejection fraction, restrictive cardiomyopathy, and unexplained left ventricular hypertrophy. Tc-99m pyrophosphate (PYP) imaging has emerged as a pivotal, non-invasive test for diagnosing transthyretin cardiac amyloidosis (ATTR-CM) and has dramatically reduced the need for endomyocardial biopsy in appropriate clinical settings. --- What is Tc-99m PYP Imaging? Tc-99m PYP imaging is a nuclear scintigraphy technique that uses technetium-99m–labeled pyrophosphate, a bone-seeking tracer. In the heart, this tracer shows avid uptake in myocardium infiltrated by transthyretin amyloid, while uptake is minimal or absent in light-chain (AL) amyloidosis. --- Why is it Important? Provides non-invasive diagnosis of ATTR-CM Helps differentiate ATTR from AL amyloidosis Avoids unnecessary endomyocardial biopsy Enables early diagnosis and treatment, especially in HFp...